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Modified Single-Loop Reconstruction for Pancreaticoduodenectomy.
J Vis Exp 2019; (151)JV

Abstract

Modified single-loop reconstruction in pancreaticoduodenectomy separates pancreatic secretion from bile. It is performed in cases of high-risk pancreatic remnants to reduce the severity of postoperative pancreatic fistulas and moreover the overall postoperative morbidity. This reconstruction technique is characterized by an extra-long jejunal loop for the construction of the pancreaticojejunostomy and hepaticojejunostomy. The longer distance between these anastomoses and an additional jejuno-jejunostomy between the afferent and efferent limb of the hepaticojejunostomy separate the fluids and prevent backflow of bile towards the pancreaticojejunostomy. Thus, the secretions cannot activate each other and aggravate an existing anastomotic leakage. We observed a reduced rate of severe postoperative pancreatic fistulas after modified single-loop reconstruction compared to conventional single loop reconstruction. The technique is easy to perform, safe, and less time-consuming than a traditional double-loop reconstruction.

Authors+Show Affiliations

Department of General and Visceral Surgery, St. Josef Hospital, Ruhr University Bochum.Department of General and Visceral Surgery, St. Josef Hospital, Ruhr University Bochum.Department of General and Visceral Surgery, St. Josef Hospital, Ruhr University Bochum.Department of General and Visceral Surgery, St. Josef Hospital, Ruhr University Bochum.Department of General and Visceral Surgery, St. Josef Hospital, Ruhr University Bochum; o.belyaev@klinikum-bochum.de.

Pub Type(s)

Journal Article
Video-Audio Media

Language

eng

PubMed ID

31609317

Citation

Luu, Andreas M., et al. "Modified Single-Loop Reconstruction for Pancreaticoduodenectomy." Journal of Visualized Experiments : JoVE, 2019.
Luu AM, Aghalarov I, Braumann C, et al. Modified Single-Loop Reconstruction for Pancreaticoduodenectomy. J Vis Exp. 2019.
Luu, A. M., Aghalarov, I., Braumann, C., Uhl, W., & Belyaev, O. (2019). Modified Single-Loop Reconstruction for Pancreaticoduodenectomy. Journal of Visualized Experiments : JoVE, (151), doi:10.3791/59319.
Luu AM, et al. Modified Single-Loop Reconstruction for Pancreaticoduodenectomy. J Vis Exp. 2019 Sep 28;(151) PubMed PMID: 31609317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modified Single-Loop Reconstruction for Pancreaticoduodenectomy. AU - Luu,Andreas M, AU - Aghalarov,Ilgar, AU - Braumann,Chris, AU - Uhl,Waldemar, AU - Belyaev,Orlin, Y1 - 2019/09/28/ PY - 2019/10/15/entrez JF - Journal of visualized experiments : JoVE JO - J Vis Exp IS - 151 N2 - Modified single-loop reconstruction in pancreaticoduodenectomy separates pancreatic secretion from bile. It is performed in cases of high-risk pancreatic remnants to reduce the severity of postoperative pancreatic fistulas and moreover the overall postoperative morbidity. This reconstruction technique is characterized by an extra-long jejunal loop for the construction of the pancreaticojejunostomy and hepaticojejunostomy. The longer distance between these anastomoses and an additional jejuno-jejunostomy between the afferent and efferent limb of the hepaticojejunostomy separate the fluids and prevent backflow of bile towards the pancreaticojejunostomy. Thus, the secretions cannot activate each other and aggravate an existing anastomotic leakage. We observed a reduced rate of severe postoperative pancreatic fistulas after modified single-loop reconstruction compared to conventional single loop reconstruction. The technique is easy to perform, safe, and less time-consuming than a traditional double-loop reconstruction. SN - 1940-087X UR - https://www.unboundmedicine.com/medline/citation/31609317/Modified_Single-Loop_Reconstruction_for_Pancreaticoduodenectomy L2 - https://dx.doi.org/10.3791/59319 DB - PRIME DP - Unbound Medicine ER -